Bert J. Rico
Founder and Chief Executive Officer
Glass box insights, not black box dashboards.
- bert.rico@clearstars.ai
- 832.234.2649
- 2717 Commercial Center Blvd., Suite E200, Katy, TX 77494
Background
Bert J. Rico is Founder and Chief Executive Officer of ClearStars, the Medicare Advantage Stars analytics and healthcare compliance company he built on one conviction: clear insights drive 5 star outcomes. He leads technology, engineering, and product, and partners with COO and Co-Founder Pedro Cerrate on marketing and sales. Bert brings nearly two decades in healthcare and Medicare Advantage quality analytics to turning CMS Star Ratings from a maze into a playbook.
Across payer operations, clinical analytics, and health plan leadership, Bert has contributed to three 5 Star CMS contracts, including leading Baylor Scott and White Health Plan to its first ever 5 Star rating. He carries deep command of Star Ratings methodology, cut points, bubble measures, and contract level performance, with fluency across quality measurement, member and provider survey instruments, electronic clinical data reporting and digital quality, health equity, and value-based care.
His impact shows up in the numbers. Selected for an NCQA field testing pilot, Bert built the measure logic, data flows, and validations for three measures using electronic clinical data, two of which are now in the measure set. He cut a health plan's audit issue log by 75 percent, removed more than $730,000 in annual analytics expense through consolidation and automation, and built the ingestion, validation, and measure logic behind a certified quality measure engine at Optum.
Bert is hands on across payer data pipelines in Snowflake, dbt, and SQL Server, and he builds and runs AI assisted analytics workflows in production. He fine-tunes self-hosted language models on CMS technical notes and Star Ratings source material while keeping all financial and measure math deterministic, so sensitive calculations never run through a generative path.
He pursued doctoral coursework in Health Informatics at UT Health Science Center at Houston and earned a B.S. in Computer Software Engineering, magna cum laude, from Barry University. At ClearStars, Bert leads engagements end to end and delivers the work personally, building the Stars intelligence, deterministic workflow AI, and FHIR first clinical outcomes engine that serve Medicare Advantage plans and their members.